Gonçalves Nuno Moreira, Carneiro Angela M, Brandão Elisete, Falcão-Reis Fernando M
Department of Ophthalmology, Hospital São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Case Rep Ophthalmol Med. 2013;2013:461758. doi: 10.1155/2013/461758. Epub 2013 Apr 24.
Purpose. To present a case study of a monocular acquired vitelliform lesion, studied with multimodal fundus imaging (spectral-domain-optical coherence tomography, fundus autofluorescence, and fluorescein angiography) with a followup of three years. Case Report. An asymptomatic macular lesion was detected on a 64-year-old man. Fundus exam revealed a macular lesion with an apparent horizontal level associated with multiple round small whitish lesions, suggestive of cuticular drusen. He was studied with autofluorescence of the fundus (FAF), fluorescein angiography (FA), spectral domain-optical coherence tomography (SD-OCT), and electrooculogram. The findings were compatible with the diagnosis of acquired vitelliform lesion, associated with cuticular drusen. After one year, the visual acuity decreased to 20/50, without identifiable alterations of the FAF, FA, or SD-OCT. Three years later, fundoscopy and imaging showed an evolution to a state similar to vitelli disruptive phase of Best disease with an improvement of visual acuity to 20/25. We report the results of FAF, FA, and SD-OCT at this stage. Conclusion. Acquired vitelliform lesions associated with cuticular drusen can present as a pseudohypopyon lesion, and the evolution to the atrophic phase can be associated with an improvement of visual acuity.
目的。介绍一例单眼获得性卵黄样病变的病例研究，该病例采用多模式眼底成像（光谱域光学相干断层扫描、眼底自发荧光和荧光素血管造影）进行研究，并随访三年。病例报告。一名64岁男性被检测出无症状黄斑病变。眼底检查发现黄斑病变有明显的水平分界线，伴有多个圆形小白色病变，提示为玻璃膜疣。对其进行了眼底自发荧光（FAF）、荧光素血管造影（FA）、光谱域光学相干断层扫描（SD-OCT）和眼电图检查。检查结果符合获得性卵黄样病变的诊断，伴有玻璃膜疣。一年后，视力降至20/50，眼底自发荧光、荧光素血管造影或光谱域光学相干断层扫描未发现可识别的改变。三年后，眼底镜检查和成像显示病情发展至类似于Best病的卵黄破碎期，视力提高到20/25。我们报告了此阶段的眼底自发荧光、荧光素血管造影和光谱域光学相干断层扫描结果。结论。与玻璃膜疣相关的获得性卵黄样病变可表现为假性前房积脓病变，发展至萎缩期可能与视力提高有关。
